Problems with therapist

[therapistquestion]

I'm having psychodynamic therapy and an having problems with my therapist.

I'm not sure what to do, she keeps coming out with things that I find upsetting. I bring them up with her and the she says something else. We started off on the wrong foot because her style of therapy is to say hello and then remain silent for the whole session while I talk.

I told her that although I appreciate that's her process, I need at least some feedback to show I'm being heard. She seems to have taken that on board but the feedback she's giving doesn't make me feel heard at all, just misunderstood.

One of our biggest problems is incongruence. I've suffered a lot of trauma both as a child and an adult and find it difficult to be vulnerable with someone I barely know and to show them that vulnerability. She keeps telling me that it sound as though I'm telling her stories. I'm not sure how to interpret that. The week before she told me that it was like I had an agenda because I wanted to talk about issues raised in the last session.

I find talking about these incidents upsetting and traumatic and feel as though that trauma is not being empathised with but misinterpreted. I am bringing these problems back into every therapy session but then something happens again that I'm finding upsetting. I feel judged. Like I should be acting in a certain way and because I'm not on the floor sobbing, I'm strange.

Try a different therapist who has a different approach. There are lots of approaches and it's personal taste. You need a therapist you gel with and trust.

Thank you for your response. This is therapy on the NHS and I'm not sure if they'll give me another therapist. It took months to actually start with this particular one. Before I started therapy, I spoke to the consultant about what to do if I have problems and she said take it into the therapy room, work it out with the therapist. I really need to focus on relationships and maybe I should be battling it out in the room rather than dropping it or changing.

Does that make sense?

What you've described is what psychodynamic therapy is. It's very much on you, and the therapist is not there to empathise or give feedback. It can be very intense.

When she says it sounds like you're telling her stories, it's ok for you to say "I'm not sure how to interpret that". She'll probably respond "What do you think I meant". That's because although you're not certain how she meant it, you will have a gut instinct as to what she meant. When you articulate that, you can then explore it further.

I didn't last the distance with psychodynamic therapy, much for the reasons you describe. I wish I could have, but eventually I had to admit I didn't feel strong enough at that time. It's OK to do that, and it shouldn't stop you getting referred again when you feel more able to deal with things.

I'd be surprised too if they offer another psychodynamic therapist, as they're quite scarce, and on what you've said, it's the therapy style you're struggling with rather than the person. You might be able to access different therapy with a more compassionate approach, possibly through a charity or low cost option.

Ah! Then if this is what the therapy is; then that's ok. I thought it was the therapist. If psychodynamic is just me in a room with a completely silent person who offers no feedback, that's what she's been doing.

I thought the therapist were meant to attune to their clients but it seems that psychodynamic therapist just stare at you for 50 minutes and say time's up. When she does give feedback, it's to say things that I don't agree with. For example, I'm upset and close to tears and she says: You seem angry and I'm actually not angry at all! I'm just really really sad. That's why I was feeling misunderstand and a lack of empathy.

I promise English is my first language!

I think it just isn't a good fit tbh. I'd look for a new therapist if I were you. My therapist is my third and I was starting to give up when I met him but we clicked and are doing good work. Sometimes you have to shop around a bit to find someone you can work well with.

I was trained in psychodynamic psychotherapy, and it really is not as inflexible as saying nothing. All therapists develop their own style. Obviously, the patient does most of the talking, but, from my perspective, I was there to reflect, interpret, inquire about any feelings coming up, and to work with the client to build a "therapeutic alliance".

It's very hard to tell whether your experience is simply part of the therapy or you have an unsympathetic therapist because, in psychodynamic psychotherapy, your therapist will, to all intents and purposes, take on the characteristics of your primary care-givers, of lovers, of abusers, at various points in the therapy due to "transference".

I would come out with it and say you're considering leaving because you don't understand the process and are finding it punitive, and she how she responds.

Hi OP, your therapist sounds like quite a traditional psychodynamic Psychotherapist: basically they present themselves a ‘blank slate’ and show as little of themselves as possible. The idea is that you will then project your assumptions and ideas about who they are/what they are like onto them. This is called the Transference and is considered in psychodynamic therapies to be the primary agent of therapeutic change. The idea is that you are likely to transfer feelings about other significant relationships in your life (eg parents) onto the therapist . They then offer interpretations of this and this helps to build insight. . I had several years of this style of therapy when I was younger and it helped in some ways, not in others. I prefer a more relational, humanistic style of therapy myself.. May I ask what you were hoping to get help with? For instance was it trauma, or anxiety or relationships etc.. ? Different models of therapy have varying effectiveness for different problems and the therapeutic relationship or ‘fit’ between client and therapist is fundamental across all modalities.

I had a therapist who gave very little feedback. After saying hello she just stared at me. Which I hated, my mind went blank and u feel like the world was starting at me. We struggled on for about 10 sessions and I did bring it up with her but she just said it was up to me to lead the sessions. I got a few good things from it but ultimately I needed more a more reflective approach.

I couldn’t handle that either. I’ve been to various therapists and they usually talk.

Can you mention to her that you are struggling with this type of therapy and is there any other style that would help you better if can she refer you for something else?

It may be a referral back through your gp and take time but it sounds like you are not getting much from her.

I don’t understand that style of therapy at all. I’ve always had empathetic people who seem to know what I’m thinking and respond to me and come up with other ways of looking at things. That helped me. Only once did I find I did not get along with a therapist. I felt he didn’t understand what I had been through because he was male but perhaps I was wrong, I just know that I didn’t feel comfortable telling him stuff.

However if this therapy is not helping and you’ve tried then it would be better to get another kind of therapy.

Good luck, I hope you get the help you want the way I did.

It might be worth reading through the info on the BACP website about what therapy is and what to expect (and even check of yojr therapist is a member) to give a general idea... www.bacp.co.uk/about-therapy/what-is-counselling/

This was pretty much my experience of psychodynamic therapy. It did help a lot in the end though.

Different people need different kinds of therapy. I had to try a few before I found one who worked in a way which helped me. I actually told her at my first meeting with her that I felt I wanted feedback and advice from her and that I needed someone to help me get rid of the anger/trauma and confusion.

Please ask for a referal to a different kind of therapist.

@SleepWellBeast why would OP need to check if her therapist is a BACP member? There are many membership bodies for counsellors and therapists, the BACP is just one (but somehow a lot of people have been convinced they are the only one or they are the best).

@therapistquestion I would recommend saying to your therapist exactly what you’ve said here, and to be as blunt and straightforward about it as you want to so you feel understood. Your therapist sounds like she has a psychodynamic or even psychoanalytic style, and if that really isn’t working for you then it’s okay to say so. Perhaps the mismatch between your expectations of what therapy would be like and what you are actually experiencing is also having an impact on how you feel about it?

And, if it really isn’t working for you, you can request a new therapist. Not every style of therapy is helpful for everyone, it’s okay (and normal!) not to get on with some types.

Checking if her therapist was a member was clearly not the focus of directing to BACP. Primarily it was about the info they have on therapy. BACP are by far the largest organisation and a good place to start. OP there's also BPC (psychoanalytic), UKCP (psychotherapists), and many others.

In my experience, therapy is primarily about the relationship between you and your therapist and you should not worry about switching if it is not right.

Sorry @SleepWellBeast. There have been so many posts on Mumsnet saying things like “you should never see anyone but a BACP member”, “if they’re not BACP then they’re no good”, or describing someone as “BACP-qualified” (BACP don’t offer qualifications!) etc that I’ve become rather frustrated at the incorrect information.

@ChaChaCha2012

What you've described is what psychodynamic therapy is. It's very much on you, and the therapist is not there to empathise or give feedback. It can be very intense.

When she says it sounds like you're telling her stories, it's ok for you to say "I'm not sure how to interpret that". She'll probably respond "What do you think I meant". That's because although you're not certain how she meant it, you will have a gut instinct as to what she meant. When you articulate that, you can then explore it further.

I didn't last the distance with psychodynamic therapy, much for the reasons you describe. I wish I could have, but eventually I had to admit I didn't feel strong enough at that time. It's OK to do that, and it shouldn't stop you getting referred again when you feel more able to deal with things.

It's certainly a possibility. It's taken over a year from GP referral to where I am now, about a month in. It was a struggle to actually get a therapist as I had to fight my corner. The consultant wanted to give me group therapy only and compromised with a trainee. So maybe that's where the problem is, lack of experience.

As you can see, I don't know if I'd get another therapist and if I did, no idea how long that would take given the backlog. I am finding it a struggle.

@BertiesLanding

I was trained in psychodynamic psychotherapy, and it really is not as inflexible as saying nothing. All therapists develop their own style. Obviously, the patient does most of the talking, but, from my perspective, I was there to reflect, interpret, inquire about any feelings coming up, and to work with the client to build a "therapeutic alliance".

It's very hard to tell whether your experience is simply part of the therapy or you have an unsympathetic therapist because, in psychodynamic psychotherapy, your therapist will, to all intents and purposes, take on the characteristics of your primary care-givers, of lovers, of abusers, at various points in the therapy due to "transference".

I would come out with it and say you're considering leaving because you don't understand the process and are finding it punitive, and she how she responds.

Thanks. I'm not feeling the alliance and I don't feel as though my therapist is trying to understand how I express myself or why I express myself in a particular way. She also keeps telling me that I am describing painful events but am not showing that pain. I feel as though she wants me to perform for her. What I'm actually doing is trying to hold it together so I can finish what I'm saying. She is interpreting that as anger; which I find odd as I'm nowhere near angry. It's very frustrating.

She also keeps telling me that I am describing painful events but am not showing that pain. I feel as though she wants me to perform for her. What I'm actually doing is trying to hold it together so I can finish what I'm saying. She is interpreting that as anger; which I find odd as I'm nowhere near angry. It's very frustrating.

I would interpret that as her saying you are emotionally disconnected from the events you are describing, and are blocking off your emotions. Processing emotions and releasing them to heal often means allowing yourself to feel and express them. Have you told her she is wrong about what you are feeling, and how frustrated you feel with her responses?

@shivermetimbers77

Hi OP, your therapist sounds like quite a traditional psychodynamic Psychotherapist: basically they present themselves a ‘blank slate’ and show as little of themselves as possible. The idea is that you will then project your assumptions and ideas about who they are/what they are like onto them. This is called the Transference and is considered in psychodynamic therapies to be the primary agent of therapeutic change. The idea is that you are likely to transfer feelings about other significant relationships in your life (eg parents) onto the therapist . They then offer interpretations of this and this helps to build insight. . I had several years of this style of therapy when I was younger and it helped in some ways, not in others. I prefer a more relational, humanistic style of therapy myself.. May I ask what you were hoping to get help with? For instance was it trauma, or anxiety or relationships etc.. ? Different models of therapy have varying effectiveness for different problems and the therapeutic relationship or ‘fit’ between client and therapist is fundamental across all modalities.

Thanks. I'm seeing the therapist for help with relationships as I keep getting into the same problems. This is why trying to work this out rather than stopping therapy would be helpful, I think. I just see the current set up as we're both on opposite sides of the room in our own camps. I'm telling her deeply personal, traumatic things and she is expressionless, looking at me and saying nothing. Then when she does, it's not acknowledging what I've said, it's talking about how I'm saying it, like I'm auditioning for a part. I don't really see how I'm saying something is important, I think what's important is that I'm talking about it and then we can see how that relates to the relationship difficulties.

Perhaps she is mirroring you.

@MajesticWol

She also keeps telling me that I am describing painful events but am not showing that pain. I feel as though she wants me to perform for her. What I'm actually doing is trying to hold it together so I can finish what I'm saying. She is interpreting that as anger; which I find odd as I'm nowhere near angry. It's very frustrating.

I would interpret that as her saying you are emotionally disconnected from the events you are describing, and are blocking off your emotions. Processing emotions and releasing them to heal often means allowing yourself to feel and express them. Have you told her she is wrong about what you are feeling, and how frustrated you feel with her responses?

Thanks. I see what you mean and this is something we've discussed. The problem is, I was really badly bullied throughout childhood, so showing how I felt, even though I was feeling it led to more bullying. I may not show on my face that I'm in pain while talking about it, but I am actually feeling that pain.

Some of this does sound v familiar to me from my psychodynamic therapy - it's a long process and v intense.

Saying 'Hello' and just leaving you to start was pretty normal. My head would be spinning when I left, I'd spend the week thinking about things and then I would to some extent have prepped what I wanted to talk about. I soon learned if I sat there in silence not saying anything, the session would be gone - and in effect that was part of the therapy.

Her saying 'it's time to stop now' - yes, mine did that. Again, part of the therapy was learning how to get across what I wanted to say and use the time effectively. But on the other hand, don't worry! This therapy takes time - I took 3 years and only stopped because I moved house! It probably took me a whole year just to figure out how to deal with 'it's time to stop now' - and again, sometimes being angry with your therapist and learning how to deal with that anger in a healthy way is part of the process.

It would be OK, for example to say to her 'I don't like it when you say x' and then you could explore it. Or as you have described 'No, I'm not angry, I'm really really sad and holding it back in. I feel like you don't listen when I describe my emotions'.